Criminal Justice ProjectCriminal Justice Intervention Team Activity in Liverpool (2019/20)

December 2020

Public Health Institute, Faculty of Health, Liverpool John Moores University, 3rd Floor, Exchange Station, Tithebarn Street, Liverpool, L2 2QP

www.ljmu.ac.uk/phi k.a.critchley@ljmu.ac.uk 0151 231 4290 twitter.com/PHI_IMS

Karen Critchley and Mark Whitfield

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 1

CONTENTS

Key findings ............................................................................................................................................................. 2

Introduction............................................................................................................................................................. 3

Overview .................................................................................................................................................................. 4

Criminal justice routes in Liverpool ................................................................................................................ 4

Outcomes following criminal justice assessment ......................................................................................... 5

CJIT of residence ................................................................................................................................................. 5

Liverpool residents ................................................................................................................................................. 6

Demographics ...................................................................................................................................................... 6

Housing need ....................................................................................................................................................... 8

Substance use ...................................................................................................................................................... 9

Alcohol consumption ....................................................................................................................................... 12

Offending ........................................................................................................................................................... 14

Interventions ..................................................................................................................................................... 15

Referrals to structured treatment ............................................................................................................. 15

Recovery support sub-interventions ......................................................................................................... 15

Recommendations ................................................................................................................................................ 17

References ............................................................................................................................................................. 18

Acknowledgements .............................................................................................................................................. 18

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 2

KEY FINDINGS

• Between April 2019 and March 2020, there were 714 Criminal Justice Intervention Team (CJIT) contacts recorded by

Liverpool CJIT. Following a considerable decrease in the number of CJIT contacts between 2016/17 and 2017/18 (32%

decrease), numbers in 2018/19 increased by 6% when compared to the previous year, followed by a decrease of 4%

in 2019/20.

• Over half of the CJIT contacts in 2019/20 were Required Assessments (n=390; 55%), while 215 (30%) were voluntary

presentations following release from prison and 101 (14%) were other criminal justice routes.

• Over two in five of the CJIT contacts in 2019/20 were taken onto the CJIT caseload (n=307; 43%), while two in five did

not require further intervention (n=286; 40%).

• The majority of the Liverpool CJIT contacts in 2019/20 were Liverpool residents (n=679; 95%).

• Over four in five individuals who were Liverpool residents were men (n=512; 84%).

• Just under one in five individuals were aged 35-39 years (n=107; 18%), followed by clients aged 30-34 years (n=99;

16%).

• Sixteen per cent of the Liverpool residents considered themselves to have a disability (n=104).

• While the majority reported no housing problem, around one in five had some form of a housing problem (n=138;

21%), with 64 (10%) stating an urgent housing need due to being of no fixed abode.

• Just under half of the CJIT contacts in Liverpool reported non-opiate drugs as their main substance (n=323; 48%),

followed by opiate drugs (n=275; 41%) and alcohol (n=80; 12%).

• Similar proportions of Liverpool CJIT contacts reported heroin (n=269; 40%) or cocaine (n=264; 39%) as their main

substance. Around half reported crack as their second substance (n=224; 51%), followed by alcohol (n=96; 22%), while

43 (45%) reported cannabis and 27 (28%) reported alcohol as their third substance.

• There were similar proportions of clients whose route of administration of their main substance was intranasal

(n=273; 41%) or who smoked their main substance (n=266; 40%).

• Three-quarters stated that they had never injected (n=485; 75%), while 117 (18%) had previously injected but were

not currently and 43 (7%) were currently injecting.

• Around half of the men reported consuming alcohol in the 28 days prior to their CJIT assessment (n=284; 51%). Of

these, just under two in five consumed 7-15 units of alcohol daily (n=107; 38%), while 68 (24%) consumed 1-6 units,

59 (21%) consumed 16-24 units and 50 (18%) consumed 25 units and over.

• Over two in five women reported consuming alcohol in the 28 days prior to their CJIT assessment (n=45; 43%). Of

these, just under two in five consumed 7-15 units of alcohol daily (n=17; 38%), followed by just over one-quarter who

consumed 25 units and over (n=12; 27%).

• One-third reported Misuse of Drugs Act offences which prompted their current or most recent contact with the

criminal justice system (n=212; 33%), while three in ten were offences categorised as ‘other’ (n=193; 30%).

• Of the clients taken onto the CJIT caseload, 234 were referred to structured treatment in 2019/20 (204 individuals).

• In 2019/20, a total of 109 recovery support sub-intervention assessments were carried out on clients on the CJIT

caseload (99 individuals), with a total of 127 sub-interventions delivered.

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 3

INTRODUCTION

Although the Drug Interventions Programme was decommissioned as a national programme by the Home Office in 2013, Liverpool

Criminal Justice Intervention Team (CJIT) continue to collect and submit the criminal justice data set to Public Health England via

the National Drug Treatment Monitoring System (NDTMS). The aim of CJITs is to identify and engage with offenders in the criminal

justice system who use drugs and/or alcohol, and encourage them towards appropriate treatment services in order to reduce

acquisitive crime. There is a body of evidence supporting this process at reducing offending for this population (Collins et al., 2016;

Collins et al., 2017; Cuddy et al., 2015; Public Health England and Ministry of Justice, 2017). Under Merseyside Police’s targeted

drug testing process in the custody suites, if offenders test positive for specified Class A drugs (opiates and/or powder/crack

cocaine) they are required to undergo a Required Assessment (RA) with a CJIT worker. There are other routes of contact with a

CJIT, including: Conditional Cautioning; requirement by the individual’s Offender Manager; court mandated processes, such as

Restriction on Bail, pre-sentence reports, Drug Rehabilitation Requirements and Alcohol Treatment Requirements; and voluntary

presentations.

The CJIT data set captures client information, episode details (including drug and alcohol use, and offending behaviour), referrals

to structured treatment and recovery support sub-interventions. Assessments allow CJIT workers to determine whether further

intervention is required to address drug and/or alcohol use and offending, and if necessary, encourage engagement with a range

of appropriate treatment options. This is a key element of the work carried out by CJITs, as it provides wraparound support across

four key areas: drug and alcohol use (harm reduction and overdose management); offending; health (physical and psychosocial);

and, social functioning (housing, employment and relationships) (Home Office [n.d.]).

This CJIT Activity report for Liverpool presents data for clients accessing the CJIT between 1 April 2019 and 31 March 20201,2,3,4.

Where possible, comparisons to the Merseyside figures and the previous three years’ Liverpool CJIT activity have been made. This

report also provides recommendations for Liverpool Local Authority and Liverpool CJIT, in terms of targeting the efficient use of

resources and effective services in Liverpool and across Merseyside.

1 Please note that this report focuses on Liverpool residents from Figure 5 onwards. Also note that figures for gender, age and ethnicity are for individuals (Figures 5-8); however, this is not the case for other figures, as data may change for clients with more than one CJIT episode during the reporting year. 2 Throughout this report, numbers less than five have been suppressed to maintain client confidentiality. Where there is only one number less than five in a category then two numbers have been suppressed to prevent back calculations from totals (e.g. <10). 3 Note that in instances where there are blank records, or the client declines to answer, does not know or does not state a response, these have been excluded from the calculations; therefore, totals may not add up to the total number of CJIT contacts or individuals. 4 Note that percentages may not add up to 100% due to rounding.

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 4

OVERVIEW

Between April 2019 and March 2020, there were 714 Criminal Justice Intervention Team (CJIT) contacts recorded by Liverpool CJIT

(642 individuals). Following a considerable decrease in the number of CJIT contacts between 2016/17 and 2017/18 (32% decrease),

numbers have since somewhat fluctuated (Figure 1). Numbers in 2018/19 increased by 6% when compared to the previous year,

followed by a decrease of 4% in 2019/20. Conversely, three of the other Merseyside CJIT areas have seen an increase in the

number of CJIT contacts in 2019/20, which could be attributed to the 22% increase in the number of attempted drug tests carried

out by Merseyside Police in the custody suites between 2018/19 and 2019/20 (Critchley and Whitfield, 2020).

Figure 1: Trends of Liverpool CJIT contacts, 2016/17 - 2019/20

CRIMINAL JUSTICE ROUTES IN LIVERPOOL

Figure 2 shows the criminal justice routes that led to the contact with Liverpool CJIT in 2019/20. Over half of the CJIT contacts

were Required Assessments (RAs) imposed after a positive drug test for opiates and/or cocaine in a police custody suite (n=390;

55%), while 215 (30%) were voluntary presentations following release from prison and 101 (14%) were other criminal justice

routes5. The proportion of RAs in 2019/20 is lower than the previous three years and lower than the Merseyside figure (61%),

while the proportion of clients who presented voluntarily following release from prison is higher than the previous three years

and higher than the Merseyside figure (24%).

Figure 2: Referral routes of Liverpool CJIT contacts, 2019/20

5 Other criminal justice routes: Required by offender management scheme/DRR/ATR/IOM = 62; requested by Offender Manager (post DRR/ATR) = 18; voluntary - other = 8; Restriction on Bail = 5; Conditional Cautioning <5; other <5; referred by treatment provider (post treatment) <5.

1,027

697 741 714

0100200300400500600700800900

1,0001,100

16/17 17/18 18/19 19/20

390(55%)

215(30%)

101(14%)

050

100150200250300350400450

RA imposed after positive drug test Voluntary - following release from prison Other criminal justice routes

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 5

OUTCOMES FOLLOWING CRIMINAL JUSTICE ASSESSMENT

Of the 714 Liverpool CJIT contacts in 2019/20, over two in five were taken onto the CJIT caseload (n=307; 43%), while two in five

did not require further intervention (n=286; 40%) (Figure 3). The proportion of clients taken onto Liverpool CJIT’s caseload in

2019/20 is similar to the previous year (41%), though lower than in 2016/17 (59%) and 2017/18 (48%), and notably it is the lowest

proportion of the five Merseyside areas in 2019/20 (Merseyside total: 53%). The proportion of clients who did not require further

intervention in 2019/20 is an increase on the previous year (33%) and the highest proportion of the Merseyside CJITs (Merseyside

total: 21%).

Figure 3: Outcomes following criminal justice assessment of Liverpool CJIT contacts, 2019/20

CJIT OF RESIDENCE

The majority of the Liverpool CJIT contacts in 2019/20 were Liverpool residents (n=679; 95%) (Figure 4).

Figure 4: CJIT of residence of Liverpool CJIT contacts, 2019/20

22(3%)

46(6%)

50(7%)

286(40%)

307(43%)

0 25 50 75 100 125 150 175 200 225 250 275 300 325

Already case managed by treatmentprovider/other CJIT/Offender Manager

Transferred prior to care plan

Did not want to engage

No further intervention required

Taken onto CJIT caseload

8(1%)

679(95%)

<10 *** <1012

(2%)0

100

200

300

400

500

600

700

800

Knowsley Liverpool Sefton St Helens Wirral Outside of Merseyside

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 6

LIVERPOOL RESIDENTS

DEMOGRAPHICS

Of the 679 CJIT contacts who were Liverpool residents, there were 608 individuals. Over four in five individuals in contact with

Liverpool CJIT in 2019/20 were men (n=512; 84%) (Figure 5). This is the same as the Merseyside figure and although it is an increase

on the previous year’s proportion (81%), it is the same as the proportion in 2017/18.

Figure 5: Gender of Liverpool CJIT contacts (individuals), 2019/20

The average age of the CJIT contacts in 2019/20 was 37 years, which is the same as the previous year. Looking at age groups, just

under one in five individuals were aged 35-39 years (n=107; 18%), followed by clients aged 30-34 years (n=99; 16%) (Figure 6).

Proportions are similar to previous years and the Merseyside figures.

Figure 6: Age group of Liverpool CJIT contacts (individuals), 2019/20

512(84%)Men

96(16%)

Women

82(13%)

88(14%)

99(16%)

107(18%)

85(14%) 76

(13%) 71(12%)

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

18-24 25-29 30-34 35-39 40-44 45-49 50+

Merseyside

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 7

Figure 7 shows some differences in age group proportions across gender groups in Liverpool. Whilst there are fewer female CJIT

contacts, there were considerably larger proportions aged 30-34 years, 35-39 years and 45-49 years (21%, 23% and 18%

respectively) when compared to men (15%, 17% and 12% respectively). Conversely, there were substantially lower proportions of

women aged 18-24 years and 25-29 years (8% and 5% respectively) when compared to men (14% and 16% respectively).

Figure 7: Age group and gender of Liverpool CJIT contacts (individuals), 2019/20

Just over nine in ten of the Liverpool CJIT contacts identified themselves as White British (n=546; 92%) (Figure 8), which is lower

than the Merseyside proportion (95%).

Figure 8: Ethnicity of Liverpool CJIT contacts (individuals), 2019/20

Sixteen per cent of the Liverpool residents considered themselves to have a disability (n=104) (Figure 9), which is considerably

lower than the Merseyside proportion (25%).

Figure 9: Liverpool CJIT contacts with a disability, 2019/20

14% 16

%

15% 17

%

14%

12%

12%

8%

5%

21%

23%

13%

18%

13%

0%

5%

10%

15%

20%

25%

18-24 25-29 30-34 35-39 40-44 45-49 50+

Men Women

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 8

The 104 clients who considered themselves to have a disability reported a total 135 disabilities6. Over one-third of the disabilities

were behaviour and emotional (n=48; 36%), followed by progressive conditions and physical health (n=36; 27%), other disabilities

(n=18; 13%), and mobility and gross motor (n=14; 10%) (Figure 10).

Figure 10: Disability type of Liverpool CJIT contacts, 2019/20

HOUSING NEED

While the majority of the Liverpool CJIT contacts reported no housing problem, around one in five had some form of a housing

problem (n=138; 21%) (Figure 11), with 64 (10%) stating an urgent housing need due to being of no fixed abode. The proportion

of Liverpool residents who stated some form of a housing problem has increased year-on-year (from 15% in 2016/17), though it

is lower than the Merseyside figure (25%).

Figure 11: Liverpool CJIT contacts with a housing problem, 2019/20

6 Please note that clients may have up to three disabilities recorded.

***

***

***

***

***

9

14

18

36

48

0 5 10 15 20 25 30 35 40 45 50 55

Hearing

Perception of physical danger

Speech

Manual dexterity

Sight

Learning disability

Mobility and gross motor

Other

Progressive conditions and physical health

Behaviour and emotional

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 9

SUBSTANCE USE

In 2019/20, just under half of the CJIT contacts in Liverpool reported non-opiate drugs as their main substance (n=323; 48%),

followed by opiate drugs (n=275; 41%) and alcohol (n=80; 12%) (Figure 12). Although the proportion of non-opiates recorded as

the main substance has increased year-on-year (from 38% in 2016/17), it is slightly lower than the Merseyside figure (51%), while

the proportion of opiates recorded as the main substance is similar to the previous year (40%) and slightly higher than the

Merseyside figure (39%).

The main substance had the highest proportion of opiate drugs (n=275; 41%), while non-opiate drugs were highest for the second

substance (n=308; 71%) (Figure 12).

Figure 12: Substance type of Liverpool CJIT contacts, 2019/20

When the main, second and third substances are combined (n=1,210), equal proportions reported use of cocaine (n=301; 25%)

and heroin (n=300; 25%), followed by crack (n=269; 22%) and alcohol (n=203; 17%). The proportion of Liverpool CJIT contacts who

reported cocaine has increased year-on-year (from 20% in 2016/17), though it is similar to the Merseyside figure (24%), while the

proportion of heroin is slightly higher than the previous two years (23% in both 2017/18 and 2018/19) and slightly higher than the

Merseyside figure (23%).

Figure 13 shows figures split by substance one, two and three. Similar proportions of Liverpool CJIT contacts reported use of heroin

(n=269; 40%) or cocaine (n=264; 39%) as their main substance. These proportions are the same as the previous year and the

proportion of cocaine is the same as the Merseyside figure, while the proportion of heroin is slightly higher than the Merseyside

figure (38%). Around half of the Liverpool CJIT contacts in 2019/20 reported crack as their second substance (n=224; 51%),

followed by alcohol (n=96; 22%), while 43 (45%) reported cannabis and 27 (28%) reported alcohol as their third substance (Figure

13).

12%22% 28%

48%

71%66%

41%

7% 6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Substance 1 Substance 2 Substance 3

Alcohol Non-opiates Opiates

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 10

Figure 13: Substances used by Liverpool CJIT contacts, 2019/20

Figure 14 shows the proportions of the main substance by gender. There was a substantially larger proportion of cocaine recorded

as the main substance by men (42%) when compared to women (20%), while there were larger proportions of women who

reported using alcohol, crack or heroin (21%, 9% and 47% respectively) when compared to men (10%, 6% and 38% respectively).

Figure 14: Main substance and gender of Liverpool CJIT contacts, 2019/20

12%

2%

39%

6%

40%

1% 0%

22%

9%

7%

51%

7%

1% 4%

28%

45%

8%

3%

2%

4%9%

0%

10%

20%

30%

40%

50%

60%

70%

Alcohol Cannabis Cocaine Crack Heroin Other opiates Other

Substance 1 Substance 2 Substance 3

10%

2%

42%

6%

38%

1% 0%

21%

1%

20%

9%

47%

2%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Alcohol Cannabis Cocaine Crack Heroin Other opiates Other

Men Women

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 11

Figure 15 shows the proportions of the main substance for each age group. In general, there were larger proportions of cocaine

recorded as the main substance in the younger age groups and larger proportions of heroin across the older age groups. The

majority of 18-24 year olds (85%) and over three in five 25-29 year olds (63%) reported cocaine as their main substance. Meanwhile,

just under two-thirds of 40-44 year olds (64%) and around three in five 45-49 year olds (59%) reported heroin as their main

substance. Furthermore, proportions for alcohol and crack were highest for clients aged 50 years and over (19% and 11%

respectively).

Figure 15: Main substance and age group of Liverpool CJIT contacts, 2019/20

There were similar proportions of clients whose route of administration of their main substance was intranasal (n=273; 41%) or

who smoked their main substance (n=266; 40%) (Figure 16). The proportion whose route of administration of their main substance

was intranasal has increased year-on-year (from 28% in 2016/17) and is slightly higher than the Merseyside figure (39%), while

the proportion who smoked their main substance is lower than the previous three years and slightly lower than the Merseyside

figure (42%).

Figure 16: Route of administration of the main substance used by Liverpool CJIT contacts, 2019/20

2%

10%

10%

15%

12%

15%

19%

6%

3%

3%

1%

1%

3%

85%

63%

43%

31%

18%

16%

24%

1%

3%

9%

7%

4%

9%

11%

4%

18%

35%

46%

64%

59%

43%

1%

1%

1%

1%

1%

1%

1%

1%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

18-24

25-29

30-34

35-39

40-44

45-49

50+

Alcohol Cannabis Cocaine Crack Heroin Other opiates Other

273(41%)Sniff

266(40%)

Smoke

84(13%)Oral

47(7%)

Inject

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 12

Figure 17 shows that three-quarters of Liverpool CJIT contacts in 2019/20 stated that they had never injected (n=485; 75%), while

117 (18%) had previously injected but were not currently and 43 (7%) were currently injecting. The proportion of clients who

previously injected is higher than the previous year (15%), though lower than in 2016/17 and 2017/18 (22% and 20% respectively),

and lower than the Merseyside figure in 2019/20 (21%). The proportion of clients currently injecting is the same as the previous

year, though lower than in in 2016/17 and 2017/18 (11% in both years), and the same as the 2019/20 Merseyside figure.

Figure 17: Injecting status of Liverpool CJIT contacts, 2019/20

ALCOHOL CONSUMPTION

Figure 18 shows the number of days alcohol was consumed by Liverpool clients in the 28 days prior to their CJIT contact. Around

half of the men did not consume alcohol in the 28 days prior to their assessment (n=269; 49%), while around three in ten reported

drinking alcohol 1-4 days (n=161; 29%). Overall, 284 (51%) men reported to consume alcohol in the 28 days prior to their

assessment, which is similar to the previous year (52%) and slightly higher than the Merseyside figure (49%).

For women, less than three in five did not consume alcohol in the 28 days prior to their CJIT contact (n=59; 57%), while 20 (19%)

reported drinking alcohol 1-4 days and 12 (12%) reported drinking 25-28 days (Figure 18). Overall, 45 (43%) women reported to

consume alcohol in the 28 days prior to their assessment, which is a higher proportion than the previous three years and the same

as the Merseyside figure (43%).

485(75%)

Never injected

117(18%)

Previously injected

43(7%)

Currently injecting

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 13

Figure 18: Number of drinking days in the 28 days prior to assessment for Liverpool CJIT contacts, 2019/20

The daily average number of units of alcohol consumed by Liverpool clients in the 28 days prior to CJIT contact are shown in Figure

19. Of the 284 men who did drink in the 28 days prior to their assessment, just under two in five consumed 7-15 units of alcohol

daily (n=107; 38%), followed by around one-quarter who consumed 1-6 units (n=68; 24%). Around one in five consumed 16-24

units daily (n=59; 21%) and just under one in five reported drinking 25 units and over (n=50; 18%). The proportion of men who

consumed 1-6 units of alcohol daily is higher than the previous three years and higher than the Merseyside figure (20%), while for

those who drank 7-15 units it is the same as the previous year, though higher than in 2016/17 and 2017/18, and slightly lower

than the Merseyside figure (40%). The proportion of men who reported to consume 16-24 units of alcohol daily is lower than the

previous three years and lower than the Merseyside figure (24%), while the proportion who consumed 25 units and over is also

lower than the previous three years, though slightly higher than the Merseyside figure (16%).

Of the 45 women who did drink in the 28 days prior to their CJIT contact, just under two in five consumed 7-15 units of alcohol

daily (n=17; 38%), followed by just over one-quarter who consumed 25 units and over (n=12; 27%) (Figure 19). Notably, the

proportion of women who consumed 25 units or more of alcohol daily is higher than the previous three years and higher than the

Merseyside figure (21%).

Figure 19: Number of units of alcohol (daily average) consumed by Liverpool CJIT contacts, 2019/20

49%

29%

7%4%

2% 1% 0%

8%

57%

19%

4% 4% 2% 1% 2%

12%

0%

10%

20%

30%

40%

50%

60%

0 1 to 4 5 to 8 9 to 12 13 to 16 17 to 20 21 to 24 25 to 28

Men Women

24%

38%

21%18%

16%

38%

20%

27%

0%

5%

10%

15%

20%

25%

30%

35%

40%

1 to 6 7 to 15 16 to 24 25+

Men Women

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 14

OFFENDING

The offence that prompted Liverpool CJIT clients’ current or most recent contact with the criminal justice system is shown in Figure

20. One-third were Misuse of Drugs Act (MDA) offences (n=212; 33%)7, while three in ten were offences categorised as ‘other’

(n=193; 30%). Over one in ten were theft - shoplifting (n=81; 13%) and around one in ten were wounding or assault (n=69; 11%).

The proportion of MDA offences is slightly higher than the Merseyside figure (31%) and has increased year-on-year (from 24% in

2016/17), while the proportion of ‘other’ offences is also higher than the Merseyside figure (25%) and higher than the previous

three years.

Figure 20: Offence that prompted current or most recent contact with the criminal justice system for Liverpool CJIT contacts, 2019/20

Figure 21 shows the proportions of the main substance for the most common offences. Heroin recorded as the main substance

was most prominent for those whose contact with Liverpool CJIT was prompted by theft - shoplifting (80%), while for cocaine, it

was MDA offences (70%).

Figure 21: Main substance and offence of Liverpool CJIT contacts, 2019/20

7 Around nine in ten of the MDA offences were possession (n=193; 91%), while the remainder were supply (n=19; 9%).

212(33%) 193

(30%)

81(13%) 69

(11%)32

(5%)26

(4%) 14(2%)

11(2%) *** *** *** *** ***

0

25

50

75

100

125

150

175

200

225

29%

4%

20%

1%

1%

2%

4%

36%

9%

32%

70%

4%

6%

4%

8%

28%

80%

42%

17%

3%

1%

0%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100%

Wounding or assault

Theft - shoplifting

Other

MDA offences

Alcohol Cannabis Cocaine Crack Heroin Other opiates Other

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 15

INTERVENTIONS

REFERRALS TO STRUCTURED TREATMENT

Of the clients taken onto the CJIT caseload, 234 were referred to structured treatment in 2019/20 (204 individuals) (Figure 22)8.

Figure 22: Referrals to structured treatment for Liverpool CJIT contacts, 2019/20

RECOVERY SUPPORT SUB-INTERVENTIONS

In 2019/20, a total of 109 recovery support sub-intervention assessments were carried out on clients on the CJIT caseload (99

individuals), with a total of 127 sub-interventions delivered (Figure 23)8.

Figure 23: Recovery support sub-intervention assessments for Liverpool CJIT contacts, 2019/20

8 Clients not taken onto the CJIT caseload, and clients with the same caseload start date and discharge date (as these are deemed to have not been taken onto the CJIT caseload), have been excluded from these figures. Figures include referrals to structured treatment or recovery support sub-intervention assessments where the date was between 1 April 2019 and 31 March 2020, regardless of when the client was taken onto the CJIT caseload.

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 16

Of the total recovery support sub-interventions delivered, around two-thirds were evidence-based psychosocial interventions to

support relapse prevention (n=84; 66%), followed by just under one-quarter being recovery check-ups (n=29; 23%) (Figure 24).

Figure 24: Recovery support sub-intervention delivered to Liverpool CJIT contacts, 2019/20

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29

84

0 10 20 30 40 50 60 70 80 90

Family support

Parenting support

Housing support

Employment support

Mental health interventions

Education and training support

Peer support involvement

Facilitated access to mutual aid

Recovery check-ups

Evidence-based psychosocial interventions to support relapseprevention

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 17

RECOMMENDATIONS

• In order to have a comprehensive understanding of substance use and the criminal justice system in the local area,

stakeholders should use this report and other Criminal Justice Project reports alongside data available from other Public

Health Institute monitoring systems (e.g. drug-related deaths, Integrated Monitoring System), as well as Public Health

England data sets (e.g. NDTMS) and local treatment services. Such information can be used as part of the local health

needs assessment, potentially contribute to the Joint Strategic Needs Assessment and be used collaboratively to help

improve the lives of offenders who use drugs and/or alcohol in Liverpool and Merseyside.

• All partners in the CJIT process should utilise all available data, which allow us to look at trends over time. This information

will enable stakeholders to stay informed, up to date and observe any changes and/or trends within Liverpool Local

Authority and across Merseyside, as well as investigating the reasons for these trends. This could help to evidence any

process changes that may be needed, in addition to highlighting potential gaps or barriers that may prevent these clients

from engaging with treatment services.

• As well as identifying the routes that led to contact with the CJIT, the data set enables client profiling; including gender,

age, ethnicity, disability, housing need, substance use, alcohol consumption and offending. This information is key to

identifying likely presenters to Liverpool CJIT and can influence resources and services required to cater for the needs of

these individuals. In keeping with the Government’s Drug Strategy (HM Government, 2017), clients need to be assessed

on a person-by-person basis and such information should inform decisions relating to the most appropriate treatment

for that individual. With resources and budgets constantly under scrutiny, this information should be used regularly to

ensure that these individuals receive effective treatment and interventions are demonstrated to provide appropriate

support with quality outcomes.

• Liverpool CJIT and the commissioners should identify and monitor the differences between the local area and the other

Merseyside areas. Key stakeholders should consider these differences and assess whether the approaches, treatment

availability, health improvement and community safety campaigns are appropriate for Liverpool Local Authority,

reflecting the differences in service specifications when procuring services.

• In 2018, PHE introduced data quality metrics, accessible via CJIT reporting on NDTMS. The purpose of the metrics is to

assist treatment providers in improving data quality of submitted data, with each metric highlighting incomplete or

anomalous data. Data quality reports should be accessed routinely and any data quality issues should be addressed.

These recommendations are unlikely to be achieved without sustained working between all stakeholders; however, their

implementation would likely aid offenders who use drugs and/or alcohol in being referred to treatment services appropriately

and having an effective treatment experience with sustainable outcomes.

Criminal Justice Project: CJIT Activity in Liverpool (2019/20) 18

REFERENCES

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programmes: UK case study. Journal of Addictive Diseases, vol. 36, pp.5-13. DOI: 10.1080/10550887.2016.1182299.

Collins, P., Critchley, K. and Whitfield, M. (2017). Criminal Justice Project: Drug Interventions Programme - Re-offending of clients

testing positive for class A drugs across Merseyside. Liverpool: Public Health Institute, Liverpool John Moores University.

Available at: https://www.ljmu.ac.uk/~/media/phi-

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Critchley, K. and Whitfield, M. (2020). Criminal Justice Project: Class A drug tests in Merseyside Police custody (2019/20).

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Liverpool: Public Health Institute, Liverpool John Moores University. Available at: https://www.ljmu.ac.uk/~/media/phi-

reports/pdf/2015_09_dip_merseyside_an_evaluation_of_dips_impact_on_offending.pdf [Accessed August 2020].

HM Government (2017). 2017 Drug Strategy. London: Home Office. Available at:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/628148/Drug_strategy_2017.PDF [Accessed

August 2020].

Home Office [no date]. Drug Interventions Programme Operational Handbook. London: Home Office. Available at:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/118069/DIP-Operational-Handbook.pdf

[Accessed August 2020].

Public Health England and Ministry of Justice (2017). The impact of community-based drug and alcohol treatment on re-

offending. London: Public Health England and Ministry of Justice. Available at: http://www.drugsandalcohol.ie/28059/1/PHE-

Community_based_drug_and_alcohol_treatment.pdf [Accessed August 2020].

ACKNOWLEDGEMENTS

With thanks to the drug and alcohol treatment provider in Liverpool and the commissioner at Liverpool Council for their continued

support. Thanks also Jennifer Germain at the Public Health Institute for her help in proof reading this report.